COVID-19Heart DiseaseInfectious DiseasesPreventive MedicineRespiratory

COVID-19 VACCINE-MYOCARDITIS LINK INSIGNIFICANT

Last summer, there was a lot of fuss about a link between mRNA vaccines for COVID-19 and the occurrence of myocarditis in young people. Reports of cases of heart muscle inflammation (myocarditis) in people under age 21, especially males, who had recently received one of the three available COVID-19 vaccines were causing a big stir, especially among those opposed to vaccines. 

Several months later, we now know that link was weak, and that research has found “COVID-19 vaccine-related cases of myocarditis uncommon and mostly mild.” These vaccines are “91% effective at preventing complications of severe [infection] including hospitalization and death. Benefits far exceed the very rare risks of adverse events, including myocarditis.” 

This confirmation is the result of research done by a University of Utah pediatric cardiologist. She identified “146 episodes of…suspected vaccine-associated myocarditis among 145 adolescents.” After closer analysis, 140 cases were confirmed. Two-thirds of the patients were white, 91% were male, and the median age was 16 years. 94% of participants received the Pfizer-BioNTech vaccine, 3.6% the Moderna vaccine, and 0.7% the Johnson & Johnson vaccine. In two patients, the vaccine type was not known. Most patients (91.4%) developed myocarditis after the second dose, and symptoms occurred usually 2 days after getting the shot. Overall, only 18.7% (26/139) of the patients with myocarditis were sick enough to be sent to the ICU. None required life support measures and none died. Their hospitalizations ranged from 0-10 days, and the median length of stay was only 2 days.

A more recent study from Israel, where they seem to be very interested in reporting their data, showed that up to 42 days after vaccination, there were only 2.13 cases of myocarditis per 100,000 people. That’s roughly 53 cases of myocarditis out of 2.5 million vaccine recipients. That’s an incidence of .00213%. According to CDC statistics, as of December 16, 2021, the U.S. recorded 1947 cases of myocarditis among the 240.3 million people vaccinated. That translates to one case of myocarditis for every 123,421 people vaccinated, or an incidence of .00081%. That’s not a lot of cases, but if you’re one of them, it’s a different very real.

490 million doses of vaccine have been given to 240.3 million Americans. That means 72.4% of the population has received one dose, 61.4% have received two doses, and an additional 57.1 million have received a booster (third shot). 

The conclusions drawn from this evaluation are that cases of COVID-19 vaccine-associated myocarditis occur mostly in young adults and teens and are UNCOMMON, MILD in severity, and NOT FATAL. 

The president of the American Heart Association, AHA, who was not involved in the study, overwhelmingly endorsed the vaccine and made a particular point to emphasize the benefits of vaccination for COVID-19 far exceed the risk of myocarditis.

Dr. G’s Opinion: I couldn’t agree more with the AHA and this study’s conclusion. My wife and I received our Pfizer vaccine doses as soon as we could schedule appointments. We experienced no major immediate effects, and now feel more secure in the activities of our daily lives, especially after our third doses. It’s unrealistic to think you can give millions of people a vaccination and have no adverse effects. It’s just not possible. Every human body is different and every human immune system reacts differently to foreign substances challenging it’s reactivity. So it’s not surprising that an incredibly small number of COVID-19 vaccine recipients would develop an unusual reaction like myocarditis. Those affected by it have recovered so I don’t see a worrisome trend.

All my years in practice, I was a strong advocate for vaccinations of all varieties, and I still am! I administered them daily. The knowledge that vaccine-related myocarditis is uncommon and mild will hopefully not discourage people from being vaccinated and reassure them of its safety. 

Reference: https://www.practicalcardiology.com/view/most-cases-of-vaccine-associated-myocarditis-have-mild-course-resolve-quickly

Caforia ALP. Receipt of mRNA vaccine against COVID-19 and Myocarditis. NEJM 2021 Dec 2;385(23):2189-2190.

https://www.cdc.gov/COVID-data-tracker-weekly-review

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